Business Contractors Quote Form

Fill out the form below to obtain a customized Business Contractors quote.

Be careful to include this information before submitting your form. All fields with asterisks are required.
No coverage or changes will take place until you receive a confirmation from the agency.

General Information

Organization Type

Contractor Type

Complete if Residential or Remodeler Contractor

Any operation or property that is owned, leased or occupied that is not covered by this policy?

If Yes, please describe

Have you declared bankruptcy or had any financial problems in the past 7 years?

If Yes, please describe

Do you perform more than 10% of your work in a state other than your state of domicile?

If Yes, please describe

$

%

$

$

%

%

General Liability - Complete if Residential or Remodeler Contractor

Any owned autos?

Do you build/remodel condominiums or multi-family dwellings?

If Yes, please describe

Do you build/remodel commercial buildings exceeding 10,000 square feet?

If Yes, please describe

Number of Housing Starts

Percentage of work which is New Construction:

%

Percentage of work which is Remodeling:

%

General Liability- Complete if Trade Contractor

Do you have any owned autos?

Do operations include tunneling or trenching work deeper than 3 feet?

If Yes, please describe

Do you contact utility services prior to digging or working with overhead wires?

If Yes, please describe

Do you perform dam or levee work or have you done so in the last 10 years?

If Yes, please describe

Do you perform work at landfill sites or have you done so in the last 10 years?

If Yes, please describe

Do you perform any railroad track/track bed construction, repair or maintenance or have you done so in the last 10 years?

If Yes, please describe

Do you install any automatic sprinkler or fire suppression systems or have you done so in the last 10 years?

If Yes, please describe

Do you install fire alarms or smoke detectors or have you done so in the last 10 years?

If Yes, please describe

Do you install or repair gas mains(excluding hose connections) or have you done so in the last 10 years?

If Yes, please describe

Do you install, service or repair high pressure boiler systems or have you done so in the last 10 years?

If Yes, please describe

Do you apply "Exterior Insulation Finish Systems"(a/k/a "Synthetic Stucco") or have you ever done so in the past?

If Yes, please describe

Any remodeling involving foundation, structural changes or movement of load bearing walls?

If Yes, please describe

Any remodeling involving foundation, structural changes or movement of load bearing walls?

If Yes, please describe

Minimum General Liability limits required of subcontractors:

Per Occurrence

%

Aggregate

%

Contractors Equipment - Complete if requesting this coverage

Does operator have less than 2 years experience in operating the equipment?

If Yes, please comment:

Any Mobile Equipment?

Does this mobile equipment have any maintenance program in place?

If Yes, please comment:

Is equipment secured and protected when not in use?

If Yes, please comment:

Thank You!

You've completed the form. Be sure you've included your name and company name and email address. If you have any general questions or comments, please enter them in the box below, then click the submit button. Thank you for considering Tarpey Insurance. We will respond to you promptly.

General Questions/Comments:

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